How to Avoid Pseudoptosis after Lifting and Breast Reduction Mammaplasties

Main Article Content

Richard Moufarrege, MD, FRCSC
Marion Aribert, MD
Georgio Gholam,
Romain Laurent, MD
Ramy Schoucair, MD
Cyril Awaida, MD

Abstract

Pseudoptosis or “bottoming-out” is a common complication following breast reduction. It is secondary to five causal phenomena: improper determination of nipple placement, dissociation of the nipple from the gland, dissociation between different parcels of a reconstituted breast, improper evaluation of the skin to be resected and weakness of the inferior dermal arch. The total posterior pedicle breast reduction technique was described by Richard Moufarrege in 1982. It consists of dissecting the skin away from the breast tissue offering free access to all breast quadrants. This technique is known for its robust blood supply to the nipple areolar complex, the preservation of the nipple areolar complex sensation, and for the conservation of the breastfeeding function. In this article, we also elucidate the reasons why the Moufarrege Total Posterior Pedicle breast reduction technique has a lowest rate of postoperative pseudoptosis.

Article Details

How to Cite
Richard Moufarrege, MD, FRCSC, Marion Aribert, MD, Gholam, , G. ., Laurent, MD, R. ., Ramy Schoucair, MD, & Cyril Awaida, MD. (2023). How to Avoid Pseudoptosis after Lifting and Breast Reduction Mammaplasties. International Journal of Medical Science and Clinical Research Studies, 3(3), 320–329. https://doi.org/10.47191/ijmscrs/v3-i3-09
Section
Articles

References

I. Moufarrege R, Beauregard G, Bosse JP, Muller G, Papillon J, Perras C. Reduction mammoplasty by the total dermoglandular pedicle. Aesthetic Plast Surg. 1985 Sep;9(3):227–32.

II. Moufarrège R. Considérations anatomo-artistiques sur le sein. Ann Chir Plast Esthét. 2005 Oct;50(5):365–70.

III. Hidalgo DA. Y-Scar Vertical Mammaplasty: Plast Reconstr Surg. 2007 Dec;120(7):1749–54.

IV. Hidalgo DA. Vertical mammaplasty. Plast Reconstr Surg. 2005 Apr;115(4):1179–97; discussion 1198-1199.

V. Boehm K, Nahai F. Vertical reduction techniques. In: Mathes SM, editor. Plastic Surgery. VI. Philadelphia: Saunders Elsevier; 2006. pp. 585–99. In.

VI. Moufarrege R. Long term evolution with the Moufarrege Total Posterior Pedicle mammaplasty. In: The Moufarrege Total Posterior Pedicle or the Universal Mammaplasty.

VII. Altuntaş ZK, Kamburoğlu HO, Yavuz N, Dadacı M, İnce B. Long-Term Changes in Nipple-Areolar Complex Position and Inferior Pole Length in Superomedial Pedicle Inverted ‘T’ Scar Reduction Mammaplasty. Aesthetic Plast Surg. 2015 Jun;39(3):325–30.

VIII. Spear SL, Albino FP. Management of the High-Riding Nipple After Breast Reduction. Clin Plast Surg. 2016 Apr;43(2):395–401.

IX. Khan UD. Vertical Scar with the Bipedicle Technique: A Modified Procedure for Breast Reduction and Mastopexy. Aesthetic Plast Surg. 2007 Aug;31(4):337–42.

X. Azzam C, De Mey A. Vertical Scar Mammaplasty in Gigantomastia: Retrospective Study of 115 Patients Treated Using the Modified Lejour Technique. Aesthetic Plast Surg. 2007 Jun;31(3):294–8.

XI. Hofmann AK, Wuestner-Hofmann MC, Bassetto F, Scarpa C, Mazzoleni F. Breast Reduction: Modified “Lejour Technique” in 500 Large Breasts: Plast Reconstr Surg. 2007 Oct;120(5):1095–104.

XII. Lista F, Ahmad J. Vertical Scar Reduction Mammaplasty: A 15-Year Experience Including a Review of 250 Consecutive Cases: Plast Reconstr Surg. 2006 Jun;117(7):2152–65.

XIII. Atiyeh BS, Rubeiz MT, Hayek SN. Refinements of vertical scar mammaplasty: circumvertical skin excision design with limited inferior pole subdermal undermining and liposculpture of the inframammary crease. Aesthetic Plast Surg. 2005 Dec;29(6):519–31.

XIV. Voleti PB, Buckley MR, Soslowsky LJ. Tendon Healing: Repair and Regeneration. Annu Rev Biomed Eng. 2012 Aug 15;14(1):47–71.

XV. Gantwerker EA, Hom DB. Skin: Histology and Physiology of Wound Healing. Facial Plast Surg Clin N Am. 2011 Aug;19(3):441–53.

XVI. Shestak KC, Davidson EH. Assessing Risk and Avoiding Complications in Breast Reduction. Clin Plast Surg. 2016 Apr;43(2):323–31.

XVII. Barbosa MVJ, Nahas FX, Neto MAS, Ferreira LM. Keyhole pattern for preoperative marking for reduction mammaplasty. Can J Plast Surg J Can Chir Plast. 2010;18(4):130–4.

XVIII. Gumus N, Coban YK, Demýrkiran MS. Vertical Mammaplasty Marking Using the Key Hole Pattern. Aesthetic Plast Surg. 2006 Apr;30(2):239–46.

XIX. Moufarrège R, Muller GH, Beauregard G, Bosse JP, Papillon J. [Mammaplasty with a lower dermo-glandular pedicle]. Ann Chir Plast. 1982;27(3):249–54.

XX. Choi M, Unger J, Small K, Tepper O, Kumar N, Feldman D, et al. Defining the Kinetics of Breast Pseudoptosis After Reduction Mammaplasty. Ann Plast Surg. 2009 May;62(5):518–22.

XXI. Quan M, Fadl A, Small K, Tepper O, Kumar N, Choi M, et al. Defining Pseudoptosis (Bottoming Out) 3 Years After Short-Scar Medial Pedicle Breast Reduction. Aesthetic Plast Surg. 2011 Jun;35(3):357–64.

XXII. Moufarrege, R. The Moufarrege Total Posterior Pedicle Mammaplasty

http://www.emedicine.com/plastic/topic488.htm

XXIII. Moufarrege R.The Moufarrege Total Posterior Pedicle or the Functional Pedicle, Journ of Surg and Insight, March 2020.

XXIV. Moufarrege, R. Existe-t-il un rapport entre les incisions et la forme finale d’un sein ? Ann Chir Plas Esth, April 2010.

XXV. Moufarrege, R. The Golden Ratios of the Breast

XXVI. Chapter, Shiffman MA, Breast Augmentation, Springer, 2009.

XXVII. Moufarrege, R. Anatomical and artistic breast considerations. Ann Chir Plast Esthet. 2005. Secrets of the full pedicle in breast reduction surgeryAnn plast Esthet 1990

XXVIII. Moufarrege, R. Secrets of the full pedicle in breast reduction surgeryAnn plast Esthet 1990

XXIX. Moufarrege, R. THE MOUFARREGE TOTAL POSTERIOR PEDICLE OR THE UNIVERSAL MAMMAPLASTY, Textbook, Edition September 2023. www.totalpedicle.com

Most read articles by the same author(s)